[Role of nursing in physical rehabilitation]

Knowledge scale of Nursing students about sexuality of people with spinal cord injury

OBJECTIVES

to build, validate and verify the reliability of the Scale of knowledge about sexuality of people with spinal cord injury for nursing students.

METHODS

a methodological study, following the steps: 1) Construction based on literature review; 2) Validation of the content with calculation of the Content Validity Index and the Modified Kappa Coefficient; 3) Pre-test with Nursing students; and 4) Measurement of reliability by internal consistency (Cronbach's alpha).

RESULTS

the first version of the instrument presented 13 items. After validation, the items received values above 0.80 and 0.76 for the Content Validity Index and Modified Kappa Coefficient, and it was suggested to separate three items to contemplate gender-specific aspects. After pre-testing, it was recommended that the writing of two items be revised. The final scale, with 16 items, showed Cronbach's alpha equal to 0.93.

CONCLUSIONS

the constructed scale presented valid content and proved to be reliable for application with nursing students.

Specialized nursing terminology for the care of people with spinal cord injury

ABSTRACT Objective: To develop a bank of terms of specialized nursing language based on the International Classification for Nursing Practice (ICNP®) for the care of the person with spinal cord injury. Method: Descriptive, quantitative study guided by the guidelines of terminological studies. Terms were extracted from an official document of the Ministry of Health through use of a computer tool, and were standardized and mapped with the ICNP® Version 2015. Results: We identified 446 relevant terms, of which 265 were equal, 68 were similar, 23 were more comprehensive, 66 were more restricted, and 24 were not in concordance with terms of the ICNP®. Terms classified as equal and similar were considered as constant. Thus, the bank of terms consisted of 333 constant terms and 113 not contained in the classification. Terms included in the Focus, Action, Means and Location axes predominated. Conclusion: The bank of terms will contribute to the construction of the ICNP® terminology subset for the care of people with spinal cord injury.

Computer assistive technology and associations with quality of life for individuals with spinal cord injury: a systematic review

STUDY DESIGN

Systematic review.

OBJECTIVE

The purpose of the study was to identify and organize evidence regarding quality of life influenced by assistive technology related to computers for people with traumatic and non-traumatic spinal cord injury (SCI).

SETTING

Distrito Federal, Brazil.

METHODS

A search strategy was conducted on the PubMed, PEDro, LILACS, PsycINFO, and SCIELO. All types of study designs considering assistive technology to improve quality of life for individuals with SCI were included. After search strategy procedures, ten references were included to review. The methodologic quality of each study was evaluated using the Level of Evidence proposed by the Oxford Centre for Evidence-based Medicine.

RESULTS

Most of the studies showed that devices for computer access improve the quality of life of people with SCI, regardless of the level of injury and type of resource. However, the positive outcomes in the quality of life should be interpreted with caution, as several methodological limitations were observed in the articles.

CONCLUSIONS

Despite the scarcity of studies and their methodological limitations, there is evidence that assistive technology for computer access favors the quality of life of people with tetraplegia due to SCI, since it improves participation, independence, and self-esteem.

Nursing interventions for rehabilitation in Parkinson's disease: cross mapping of terms

Objective:

to perform a cross-term mapping of nursing language in the patient record with the Nursing Interventions Classification system, in rehabilitation patients with Parkinson's disease.

Method:

a documentary research study to perform cross mapping. A probabilistic, simple random sample composed of 67 records of patients with Parkinson's disease who participated in a rehabilitation program, between March of 2009 and April of 2013. The research was conducted in three stages, in which the nursing terms were mapped to natural language and crossed with the Nursing Interventions Classification.

Results:

a total of 1,077 standard interventions that, after crossing with the taxonomy and refinement performed by the experts, resulted in 32 interventions equivalent to the Nursing Interventions Classification (NIC) system. The NICs, "Education: The process of the disease.", "Contract with the patient", and "Facilitation of Learning" were present in 100% of the records. For these interventions, 40 activities were described, representing 13 activities by intervention.

Conclusion:

the cross mapping allowed for the identification of corresponding terms with the nursing interventions used every day in rehabilitation nursing, and compared them to the Nursing Interventions Classification.

REHABILITATION GROUP: BENEFITS AND BARRIERS IN THE PERSPECTIVE OF WOMEN WITH BREAST CANCER

ABSTRACT Objective: to analyze the perceptions of women with breast cancer about the benefits and barriers to the participation in rehabilitation groups, according to the Health Belief Model. Method: a descriptive study with qualitative approach, conducted in 2011. Participants were eight women, aged from 54 to 67 years, after surgery for breast cancer, and members of a rehabilitation group. Data was collected through semi-structured interviews and focus groups. thematic Content analysis of the data was performed. Results: perceived benefits: physical improvement with possibility to return to daily activities; bond with multidisciplinary team; psychological support; opportunity to share experiences, clarify doubts and feel like “equals” Perceived barriers: appointment day and time; physical space; housework; time consuming and disposal. Conclusion: women saw benefits of having a preventive health behavior; however, they recognized significant barriers that must be faced in the rehabilitation process.

[Validation of nursing interventions for patients with spinal cord injury and impaired physical mobility]

This is a descriptive study that aimed to validate the nursing interventions proposed in the Nursing Interventions Classification for the diagnosis of Impaired physical mobility in adults with sequels of spinal cord injury, based on opinions of experts in rehabilitation about each intervention proposed. The sample consisted of 54 nurses who were asked about how they consider the interventions for the nursing diagnosis. A questionnaire was administered to nurses who work at the Sarah Network of Rehabilitation Hospitals. Among the 46 interventions studied, 17 (37%) were considered essential and should be implemented; others 15 (32.6%) were considered complementary, and 14 (30.4%) should not be used and could be discarded. Nursing interventions not described in the classification and suggested by 22 nurses (40.7%) were: Care with Orthoses: Maintenance; and Care with Orthoses: Prevention.

Disreflexia autonômica e intervenções de enfermagem para pacientes com lesão medular

O presente trabalho trata-se de estudo retrospectivo realizado em 2009 que objetivou identificar diagnósticos e intervenções de enfermagem para o cuidado de pacientes com lesão medular (LM). Os dados foram coletados de 465 prontuários de pacientes com LM em processo de reabilitação. Identificou-se o diagnóstico de enfermagem Risco para disreflexia autônomica em 271 (58,3%) prontuários, dos quais 80 pacientes desenvolveram disreflexia autônomica. Predominaram homens jovens, com idade média de 35,7 anos, sendo o trauma a principal causa da LM e o nível neurológico igual ou acima da sexta vértebra torácica. As intervenções de enfermagem foram organizadas em dois grupos, um voltado para a prevenção da disreflexia autonômica e outro, para seu tratamento. Desenvolveu-se um guia de intervenções para uso na prática clínica de enfermeiros reabilitadores e para inserção em sistemas de informação. Ressalta-se a importância da retirada do estímulo causador da disreflexia autonômica como terapêutica mais eficaz e como melhor intervenção na prática de enfermagem.

Improving neuro-oncological patients care: basic and practical concepts for nurse specialist in neuro-rehabilitation

Background

Neuro-oncological population well expresses the complexity of neurological disability due to the multiple neurological deficits that affect these patients. Moreover, due to the therapeutical opportunities survival times for patients with brain tumor have increased and more of these patients require rehabilitation care. The figure of nurse in the interdisciplinary specialty of neurorehabilitation is not clearly defined, even if their role in this setting is recognized as being critical and is expanding.

The purpose of the study is to identify the standard competencies for neurorehabilitation nurses that could be taught by means of a specialization course.

Methods

A literature review was conducted with preference given to works published between January 2000 and December 2008 in English. The search strategy identified 523 non-duplicated references of which 271 titles were considered relevant. After reviewing the abstracts, 147 papers were selected and made available to a group of healthcare professionals who were requested to classify them in few conceptual main areas defining the relative topics.

Results

The following five main areas were identified: clinical aspects of nursing; nursing techniques; nursing methodology; relational and organisational models; legal aspects of nursing. The relative topics were included within each area. As educational method a structured course based on lectures and practical sessions was designed. Also multi-choices questions were developed in order to evaluate the participants’ level of knowledge, while a semi-structured interview was prepared to investigate students’ satisfaction.

Conclusions

Literature shows that the development of rehabilitation depends on the improvement of scientific and practical knowledge of health care professionals. This structured training course could be incorporated into undergraduate nursing education programmes and also be inserted into continuing education programmes for graduate nurses. Developing expertise in neuro-rehabilitation for nurses, will be critical to improve overall care and care management of patients with highly complex disabilities as patients affected by brain tumors. The next step will be to start discussing, at the level of scientific societies linked to the field of neurorehabilitation and oncology, the development of a specialisation course in neurorehabilitation nursing.